臨床整形外科48巻6号

2013年06月発行

論述

Instrumentationを併用した後方進入腰椎椎体間固定術（PLIF）後に腰仙椎装具は必要か―前向き無作為化比較試験

著者： 藤原啓恭¹ 海渡貴司² 牧野孝洋¹ 石井崇大¹ 米延策雄¹

所属機関： ¹国立病院機構大阪南医療センター整形外科 ²大阪大学大学院医学系研究科器官制御外科学（整形外科）

ページ範囲：P.545 - P.551

　背景：近年のinstrumentation技術の発展により力学的に強固な固定が後方進入腰椎椎体間固定術(PLIF)では可能となったが，後療法における装具の必要性についての検討は行われていない．

　対象と方法：今回われわれは2椎間以下のPLIF施行患者30例を無作為に装具装着群と非装着群に分類し，術後早期の臨床・画像成績を比較検討した．

　結果：術後1週時点での腰痛visual analogue scaleが装具装着群で有意に低値であったが，固定椎矯正損失，日本整形外科学会腰痛疾患治療成績判定基準(JOAスコア)改善率と，日本整形外科学会腰痛疾患治療評価質問票(JOABPEQ)有効率，Rolland-Morris Disability Questionnaire，Short Form-36，周術期合併症について両群間での有意差を認めなかった．

　まとめ：重度の骨粗鬆症症例・多椎間固定を除くPLIFの術後装具装着は期間短縮または簡略化できる可能性がある．

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